Friday, March 27, 2015

In India TB is well controlled with the Indian Government's National Tuberculosis control programme. Aleem M A .BMJ⁠ 2015;350:h1080

Editorials

Tuberculosis in India

BMJ⁠ 2015⁠; 350⁠ doi: http://dx.doi.org/10.1136/bmj.h1080 (Published 23 March 2015)⁠

Cite this as: BMJ⁠ 2015;350:h1080

Rapid response




Re: Tuberculosis in India

In India TB is well controlled with the Indian Government's National Tuberculosis control programme.

Tuberculosis is an airborne disease cause by Mycobacterium tuberculosis and can kill around 4000 people every day.

India has the world’s largest burden of tuberculosis (TB), accounting for one-fourth of all new infections. It kills nearly 300,000 people in India every year.

The incidence : prevalence ratio in India is about 1:32.

In India 40% of the country's population carries Mycobacterium tuberculosis in the passive form. Malnutrition plays an important role in activating this latent and passive TB bacteria. This poses a real threat to the 65 million underweight children in the country. The bacteria becomes active in the wake of lowered immunity which is caused by lack of nutritious food intake. The probability of developing tuberculosis amongst younger children is very high. It thus becomes crucial that a strong action plan is put in place for addressing the occurrence of this disease amongst children under 6 years of age .

World TB Day is celebrated every year to fight stigma and eliminate TB as a public health threat.

The theme of the World TB Day celebration in 2015 is “Reach, Treat, Cure Everyone”

People must know that it is a completely curable disease at very low-cost through the DOTS treatment administered by the Indian government. In India its treatments and diagnostic tests are very accessible by each and every person affected by tuberculosis. In India the Tamilnadu government is fully implementing the TB control programme.

Competing interests: No competing interests

27 March 2015

M A Aleem

Neurologist

ABC Hospital

Annamalainagar Trichy 620018 Tamilnadu India

“Poor awareness hampers fight against epilepsy” - The Hindu

“Poor awareness hampers fight against epilepsy” - The Hindu

Wednesday, March 25, 2015

“Poor awareness hampers fight against epilepsy”



TIRUCHI, March 26, 2015 THE HINDU

“Poor awareness hampers fight against epilepsy”

Epilepsy Genetic Test - Comprehensive 53-gene panel for seizure disorders genedx.com/neurology


Nahla Nainar


12 million people estimated to be epileptic in India

As the world observes Purple Day on Thursday, medical experts feel that a lot more needs to be done to create awareness about epilepsy and dispel the myths associated with the neurological disorder.

Speaking to The Hindu , Dr. M.A.Aleem, consultant neurologist and epileptologist at ABC Hospital, said “seizures, the very visible symptom of epilepsy, create panic, and often lead to mistreatment.”

Dr. Aleem is also the ‘Purple Day Ambassador’ for Tiruchi this year. The day was founded by nine-year-old Cassidy Meagan of Nova Scotia, Canada, in 2008 and it has now become a global grassroots movement (instituted formally in 2009 by New York-based Anita Kaufmann Foundation and Epilepsy Association of Nova Scotia) to raise awareness about epilepsy.

“There are several falsehoods about the disease that are reinforced by films and popular culture,” said Dr.Aleem. “Epileptics in seizure are often thought to be ‘possessed by devil,’ and the so-called traditional cures – giving the epileptic person a bunch of iron keys or jamming the patient’s mouth with a block of wood – is also dangerous. Faith-healers worsen the condition of the affected by misleading them and delaying the right treatment.”

At a press conference yesterday, Dr. M.Vikram, senior consultant neurosurgeon, Kauvery Speciality Hospital, said: “around 50 million people in the world are affected by epilepsy. In India, some 12 million are thought to be epileptics. Despite this, not many are interested in knowing more about the disease, or the right treatment for it.

“Usually, a 3 to 5 year course of medicine can help to control the disease and even cure it completely if taken regularly. There are around 150 symptoms of epileptic seizures, depending on which part of the brain has been affected,” he said.

Correctable causes, such as microbial infections, can lead to complete cure, provided the medicine regime is followed without a break, said Dr.Vikram. Hereditary conditions, however, may require life-long medication.

Epileptic patients should avoid trigger-behaviours such as sleep deprivation, prolonged computer usage, and extreme stress, he suggested.

Invasive brain surgery is one way to control some of the symptoms of epilepsy, but only if medicines didn’t help, said Dr. Vikram.

“Epileptic women can safely have conjugal relations and bear children with the help of the right type of medicines tailored to their condition,” he said.

TB detection Speedy at KAPV Govt. Medical college Trichy

TB detection Speedy at KAPV Govt. Medical college Trichy



The results for sputum test for microbacterium tuberculosis and multi-drug resistant TB (MDRTB) will be available in two hours for patients from the district, thanks to a newly-installed equipment at the microbiology department of KAP Viswanatham Government Medical College here.

The equipment, cartridge-based nucleic acid amplification test (CB-NAAT), is expected to improve the diagnosis facility and reduce the number of TB patients in the district.

The CB-NAAT was inaugurated on World TB Day during a programme organised by the health and family welfare department, Revised National Tuberculosis Control Programme (RNTCP) and National Service Scheme of Periyar EVR College.

Trichy district collector K S Palanisamy appealed to the students to disseminate facts about TB and create awareness among people to prevent them from getting infected by the disease.

"Patients should not fail to take medicines continuously otherwise they will become MDRTB patients and whoever will receive the disease from them will also be MDRTB," said Palanisamy.

Each TB patient spreads the disease to at least 10 to 15 people every year. A total of 1,522 pulmonary TB patients including 1,150 men and 372 women were identified in Trichy in 2014.

The district had 45 field staff to provide treatment to TB patients.

The CB-NAAT will ensure quick results of sputum test for TB patients at anti-retroviral therapy (ART). "CB-NAAT equipment will reduce the waiting period for the sputum test of the suspected TB patients. If the patients coming to ART centre have symptoms, their sputum will be sent to the test and results will be made available in few hours so that the treatment for TB can be started at the earliest.

Prior to the inauguration of the facility, the health officials had to wait for a long time to get the results of the sputum test from Bangalore and other places.


 

Monday, March 23, 2015

World TB Day 2015 March 24,


On World TB Day, 24 March, WHO is calling for new commitments and new action in the global fight against tuberculosis – one of the world’s top infectious killers.

There has been tremendous progress in recent years, and the world is on track to meet the Millennium Development Goal of reversing the spread of TB by 2015. But this is not enough. In 2013, 9 million people fell ill with TB and 1.5 million died.

Clearly, we all need to do more.

WHO strategy to end the global TB epidemic

Last May, at the World Health Assembly, governments agreed on ambitious new 20-year (2016-2035) strategy to end the global TB epidemic.

WHO’s End TB Strategy envisions a world free of TB with zero deaths, disease and suffering. It sets targets and outlines actions for governments and partners to provide patient-centred care, pursue policies and systems that enable prevention and care, and drive research and innovations needed to end the epidemic and eliminate TB.

On World TB Day 2015, WHO calls on governments, affected communities, civil society organizations, health-care providers, and international partners to join the drive to roll out this strategy and to reach, treat and cure all those who are ill today.


Key facts on Tuberculosis



Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent.

In 2013, 9 million people fell ill with TB and 1.5 million died from the disease.

Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top 5 causes of death for women aged 15 to 44.

In 2013, an estimated 550 000 children became ill with TB and 80 000 HIV-negative children died of TB.

TB is a leading killer of HIV-positive people causing one fourth of all HIV-related deaths.

Globally in 2013, an estimated 480 000 people developed multidrug resistant TB (MDR-TB).

The estimated number of people falling ill with TB each year is declining, although very slowly, which means that the world is on track to achieve the Millennium Development Goal to reverse the spread of TB by 2015.

The TB death rate dropped 45% between 1990 and 2013.

An estimated 37 million lives were saved through TB diagnosis and treatment between 2000 and 2013.

Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.

TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

About one-third of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.

People infected with TB bacteria have a lifetime risk of falling ill with TB of 10%. However persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill.

When a person develops active TB (disease), the symptoms (cough, fever, night sweats, weight loss etc.) may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others. People ill with TB can infect up to 10-15 other people through close contact over the course of a year. Without proper treatment up to two thirds of people ill with TB will die.

Who is most at risk?

Tuberculosis mostly affects young adults, in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.

People who are infected with HIV are 26 to 31 times more likely to become sick with TB (see TB and HIV section). Risk of active TB is also greater in persons suffering from other conditions that impair the immune system.

Over half a million children (0-14 years) fell ill with TB, and 80 000 HIV-negative children died from the disease in 2013.

Tobacco use greatly increases the risk of TB disease and death. More than 20% of TB cases worldwide are attributable to smoking.

Global impact of TB

TB occurs in every part of the world. In 2013, the largest number of new TB cases occurred in the South-East Asia and Western Pacific Regions, accounting for 56% of new cases globally. However, Africa carried the greatest proportion of new cases per population with 280 cases per 100 000 population in 2013.

In 2013, about 80% of reported TB cases occurred in 22 countries. Some countries are experiencing a major decline in cases, while in others the numbers are dropping very slowly. Brazil and China for example, are among the 22 countries that showed a sustained decline in TB cases over the past 20 years. In the last decade, the TB prevalence in Cambodia fell by almost 50%.

Symptoms and diagnosis

Common symptoms of active lung TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.

Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB. Trained laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present. With three such tests, diagnosis can be made within a day, but this test does not detect numerous cases of less infectious forms of TB.

Diagnosing MDR-TB (see Multidrug-resistant TB section below) and HIV-associated TB can be more complex. A new two-hour test that has proven highly effective in diagnosing TB and the presence of drug resistance is now being rolled-out in many countries.

Tuberculosis is particularly difficult to diagnose in children.

Treatment

TB is a treatable and curable disease. Active, drug-sensitive TB disease is treated with a standard six-month course of four antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer. Without such supervision and support, treatment adherence can be difficult and the disease can spread. The vast majority of TB cases can be cured when medicines are provided and taken properly.

Between 2000 and 2013, an estimated 37 million lives were saved through TB diagnosis and treatment.

TB and HIV

At least one-third of people living with HIV worldwide in 2013 were infected with TB bacteria, although they did not become ill with active TB. People living with HIV are 26 to 31 times more likely to develop active TB disease than people without HIV.

HIV and TB form a lethal combination, each speeding the other's progress. In 2013 about 360 000 people died of HIV-associated TB. Approximately 25% of deaths among HIV-positive people are due to TB. In 2013 there were an estimated 1.1 million new cases of TB amongst people who were HIV-positive, 78% of whom were living in Africa.

WHO recommends a 12-component approach of collaborative TB-HIV activities, including actions for prevention and treatment of infection and disease, to reduce deaths.

Multidrug-resistant TB

Standard anti-TB drugs have been used for decades, and resistance to the medicines is widespread. Disease strains that are resistant to a single anti-TB drug have been documented in every country surveyed.

Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to, at least, isoniazid and rifampicin, the two most powerful, first-line (or standard) anti-TB drugs.

The primary cause of MDR-TB is inappropriate treatment. Inappropriate or incorrect use of anti-TB drugs, or use of poor quality medicines, can all cause drug resistance.

Disease caused by resistant bacteria fails to respond to conventional, first-line treatment. MDR-TB is treatable and curable by using second-line drugs. However second-line treatment options are limited and recommended medicines are not always available. The extensive chemotherapy required (up to two years of treatment) is more costly and can produce severe adverse drug reactions in patients.

In some cases more severe drug resistance can develop. Extensively drug-resistant TB, XDR-TB, is a form of multi-drug resistant tuberculosis that responds to even fewer available medicines, including the most effective second-line anti-TB drugs.

About 480 000 people developed MDR-TB in the world in 2013. More than half of these cases were in India, China and the Russian Federation. It is estimated that about 9.0% of MDR-TB cases had XDR-TB.


24 March 2015 - the day to change gear and speed up global efforts to end TB altogether

Sunday, March 22, 2015

World Water Day 2015 March 22- Theme: Water and Sustainable Development


Humanity Needs Water



A drop of water is flexible. A drop of water is powerful. A drop of water is in demand.

Water is at the core of sustainable development. Water resources, and the range of services they provide, underpin poverty reduction, economic growth and environmental sustainability. From food and energy security to human and environmental health, water contributes to improvements in social well-being and inclusive growth, affecting the livelihoods of billions.



The theme of 2015 it’s about how water links to all areas we need to consider to create the future we want. Learn more about the theme and join the global celebrations by organizing your own event.

Join the 2015 campaign to raise awareness of water and sanitation. You can also contribute on social media though the hashtags #WaterIs and #WorldWaterDay.

World Water Day is marked on 22 March every year. It’s a day to celebrate water. It’s a day to make a difference for the members of the global population who suffer from water related issues. It’s a day to prepare for how we manage water in the future. In 1993, the United Nations General Assembly designated 22 March as the first World Water Day. 22 years later, World Water Day is celebrated around the world every year, shining the spotlight on a different issue


"To address the many challenges related to water, we must work in a spirit of urgent cooperation, open to new ideas and innovation, and prepared to share the solutions that we all need for a sustainable future."

UN Secretary-General Ban Ki-moon

World Water Day 2015 March 22- Theme: Water and Sustainable Development


Humanity Needs Water



A drop of water is flexible. A drop of water is powerful. A drop of water is in demand.

Water is at the core of sustainable development. Water resources, and the range of services they provide, underpin poverty reduction, economic growth and environmental sustainability. From food and energy security to human and environmental health, water contributes to improvements in social well-being and inclusive growth, affecting the livelihoods of billions.

2015 Theme: Water and Sustainable Development

The theme of 2015 it’s about how water links to all areas we need to consider to create the future we want. Learn more about the theme and join the global celebrations by organizing your own event.

Join the 2015 campaign to raise awareness of water and sanitation. You can also contribute on social media though the hashtags #WaterIs and #WorldWaterDay.

World Water Day is marked on 22 March every year. It’s a day to celebrate water. It’s a day to make a difference for the members of the global population who suffer from water related issues. It’s a day to prepare for how we manage water in the future. In 1993, the United Nations General Assembly designated 22 March as the first World Water Day. 22 years later, World Water Day is celebrated around the world every year, shining the spotlight on a different issue


"To address the many challenges related to water, we must work in a spirit of urgent cooperation, open to new ideas and innovation, and prepared to share the solutions that we all need for a sustainable future."

UN Secretary-General Ban Ki-moon

Saturday, March 21, 2015

Not a tragedy but a tool- BMJ⁠ 2015;350:h906

Practice

What Your Patient is Thinking

Not a tragedy but a tool

BMJ⁠ 2015⁠; 350⁠ doi: http://dx.doi.org/10.1136/bmj.h906 (Published 11 March 2015)⁠

Cite this as: BMJ⁠ 2015;350:h906

Rapid response

Re: Not a tragedy but a tool

Disabled and differently abled patients have every right to get help to transfer to a consulting room from the hospital or consultation chamber area. Hospital authorities should provide these amenities to their clients. Comfort and care of patients are important from their first step into the hospital and GP's clinic till their exit from these areas.

Competing interests: No competing interests

20 March 2015

M A Aleem

Neurologist

ABC Hospital

Annamalainagar Trichy 620018 Tamilnadu India

World Down Syndrome Day 2015 March 21

Down Syndrome- Myth and reality


This year’s World Down Syndrome Day falls as the international community is striving to create a universal, transformative agenda for sustainable development. The links between disability, human rights and development span a wide spectrum of development issues relating to economic, social and environmental factors.  Every year on this observance, we reaffirm that persons with Down syndrome are entitled to the full enjoyment of all human rights.  This year, we must make every effort to ensure that the new sustainable development goals address equality and help build a life of dignity for all, including people with Down syndrome and other persons with disabilities.

Persons with Down syndrome face stigmatization, abuse and lack of support.  Too often, their challenges begin early in life when they are excluded from quality education systems.  Adequate access to health care, early intervention programmes and inclusive education, as well as appropriate research, are vital to the growth and development of individuals with Down syndrome. 

The role of families is central to supporting persons with Down syndrome by promoting their equal status in society and empowering them to be their own advocates.  At the same time, we must recognize our collective responsibility to create conditions for all persons with disabilities to make valuable contributions to our shared future.  We must promote inclusive policies and raise awareness about social justice for people with Down syndrome, and do everything possible to enable them to live where they want and with whom, to form their own families, to administer their own assets and to pursue their own happiness.



Down syndrome is a naturally occurring chromosomal arrangement that has been a part of the human condition throughout history, in all genders, races and along all socio-economic lines. Yet despite this, many myths and false stereotypes surrounding people with Down syndrome prevail.

On World Down Syndrome Day, celebrated annually on 21 March. All should know about a few myths and facts about Down syndrome.

Myth: Down syndrome is a rare condition.

Fact: Down syndrome, or Down's syndrome, also known as trisomy 21, is a genetic condition caused by the presence of all or part of a third copy of chromosome 21. It is the most common genetic condition, with approximately 40,000 people living with Down syndrome in Britain and one baby in every 1,000 born in the UK with the condition.

In the United States, one in every 691 babies is born with Down syndrome and there are more than 400,000 people with the condition living in the US.

Myth: People with Down syndrome do not live very long.

Fact: Today, people with the condition are living into their fifties and sixties, with a number of individuals living into their seventies and beyond. Better research and awareness of Down syndrome has increased the life span of children born with the condition.

Myth: Down syndrome is hereditary and runs in families.

Fact: The condition is only hereditary in 1% of all instances, in the other 99% it is completely random. The only known factor that increases the risk is the age of the mother (over 35). However, more babies are born with the condition to mothers under 36, because more children are born within that age group of women. Translocation is the only type of Down syndrome known to have hereditary link. Translocation accounts for 3 to 4% of all cases of Down syndrome. Of those, one third (or 1% of all cases of Down syndrome) are hereditary.



Myth: People with Down syndrome have severe developmental delays.

Fact: The majority of people with Down syndrome have cognitive delays that are mild to moderate and many children with the condition will walk, talk, read and write. Many will attend ordinary schools and lead independent lives, taking part in sports, music, art and other activities. The degree of developmental delay depends on the individual. Increasingly, individuals with Down syndrome are graduating from school and going into higher education.

Myth: Adults with Down syndrome cannot be employed.

Fact: Businesses employ individuals with the condition, yet prejudice still stands in the way – a problem which is being addressed with greater awareness of Down syndrome.

Myth: People with Down syndrome are always happy.

Fact: Individuals with the condition have the same feelings as everyone else in the population, with the full range of emotions.

Myth: Adults with Down syndrome are unable to form close, interpersonal relationships.

Fact: People with Down syndrome socialise and have the same meaningful relationships as others.

Myth: Down syndrome is a disease.

Fact: Down syndrome is not a disease. People with the condition are not unwell and do not "suffer" from the condition. The health problems associated with Down syndrome depend on the individual and can be controlled with healthcare.

Myth: People with Down syndrome all look the same.

Fact: There are certain physical characteristics that can occur in individuals with the condition. People with Down syndrome can have all of them or none – a person with the condition will always look more like their close family than someone else with the condition

Friday, March 20, 2015

International Day of Happiness: 2015 . 20 March 2015





The General Assembly of the United Nations proclaimed 20 March the International Day of Happiness recognizing the relevance of happiness and well-being as universal goals and aspirations in the lives of human beings around the world and the importance of their recognition in public policy objectives.

Happiness may have different meanings for different people. But we can all agree that it means working to end conflict, poverty and other unfortunate conditions in which so many of our fellow human beings live.



The pursuit of happiness is serious business. Happiness for the entire human family is one of the main goals of the United the


For the universal happiness the world needs a new economic paradigm that recognizes the parity between the three pillars of sustainable development. Social, economic and environmental well-being are indivisible. Together they define gross global happiness.


UN Secretary-General's Message for 2015

I wish everyone around the world a very happy International Day of Happiness!

The pursuit of happiness is serious business.

Happiness for the entire human family is one of the main goals of the United Nations.

Peace, prosperity, lives of dignity for all – this is what we seek.

We want all men, women and children to enjoy all their human rights.

We want all countries to know the pleasure of peace.

We want people and planet alike to be blessed with sustainable development, and to be spared the catastrophic impacts of climate change.

Let us give thanks for what makes us happy. 

And let us dedicate our efforts to filling our world with happiness.


Tuesday, March 17, 2015

Health Issues in Women

Health Issues in Women

Dr M A Aleem
Neurologist
Trichy

International Women’s Day on March 8th – is a day to celebrate women and their achievements. It is also a day to take stock of how women’s rights, especially the right to health, are fulfilled in the world. women still are facing many health problems and we must re-commit to addressing them.

The major health problems in women are given below.

Cancer

Two of the most common cancers affecting women are breast and cervical cancers. Detecting both these cancers early is key to keeping women alive and healthy. The latest global figures show that around half a million women die from cervical cancer and half a million from breast cancer each year. The vast majority of these deaths occur in low and middle income countries where screening, prevention and treatment are almost non-existent, and where vaccination against human papilloma virus needs to take hold.

Reproductive health

Sexual and reproductive health problems are responsible for one third of health issues for women between the ages of 15 and 44 years. Unsafe sex is a major risk factor – particularly among women and girls in developing countries. This is why it is so important to get services to the 222 million women who aren’t getting the contraception services they need.


Maternal health

Many women are now benefiting from massive improvements in care during pregnancy and childbirth introduced in the last century. But those benefits do not extend everywhere and in 2013, almost 300 000 women died from complications in pregnancy and childbirth. Most of these deaths could have been prevented, had access to family planning and to some quite basic services been in place.

HIV

Three decades into the AIDS epidemic, it is young women who bear the brunt of new HIV infections. Too many young women still struggle to protect themselves against sexual transmission of HIV and to get the treatment they require. This also leaves them particularly vulnerable to tuberculosis - one of the leading causes of death in low-income countries of women 20–59 years.

Sexually transmitted infections


As already mentioned the importance of protecting against HIV and human papillomavirus (HPV) infection (the world’s most common STI). But it is also vital to do a better job of preventing and treating diseases like gonorrhoea, chlamydia and syphilis. Untreated syphilis is responsible for more than 200,000 stillbirths and early foetal deaths every year, and for the deaths of over 90 000 newborns.

Violence against women

Women can be subject to a range of different forms of violence, but physical and sexual violence – either by a partner or someone else – is particularly insidious. Today, one in three women under 50 has experienced physical and/or sexual violence by a partner, or non-partner sexual violence – violence which affects their physical and mental health in the short and long-term. It’s important for health workers to be alert to violence so they can help prevent it, as well as provide support to people who experience it.

Mental health


Evidence suggests that women are more prone than men to experience anxiety, depression, and somatic complaints – physical symptoms that cannot be explained medically. Depression is the most common mental health problem for women and suicide a leading cause of death for women under 60. Helping sensitise women to mental health issues, and giving them the confidence to seek assistance, is vital.

Non communicable diseases


In 2012, some 4.7 million women died from noncommunicable diseases before they reached the age of 70 —most of them in low- and middle-income countries. They died as a result of road traffic accidents, harmful use of tobacco, abuse of alcohol, drugs and substances, and obesity -- more than 50% of women are overweight in Europe and the Americas. Helping girls and women adopt healthy lifestyles early on is key to a long and healthy life.

Being young


Adolescent girls face a number of sexual and reproductive health challenges: STIs, HIV, and pregnancy. About 13 million adolescent girls (under 20) give birth every year. Complications from those pregnancies and childbirth are a leading cause of death for those young mothers. Many suffer the consequences of unsafe abortion.

Getting older


Having often worked in the home, older women may have fewer pensions and benefits, less access to health care and social services than their male counterparts. Combine the greater risk of poverty with other conditions of old age, like dementia, and older women also have a higher risk of abuse and generally, poor health.

When we are thinking of women and their health globally, we remind ourself : the world has made a lot of progress in recent years. We know more, and we are getting better at applying our knowledge. At providing young girls a good start in life.

And there has been an upsurge in high-level political will – evidenced most recently in the United Nations Secretary-General’s Global Strategy for Women’s and Children’s Health. Use of services, especially those for sexual and reproductive health, has increased in some countries. Two important factors that influence women’s health – namely, school enrolment rates for girls and greater political participation of women - have risen in many parts of the world.

But we are not there yet. In 2015, in too many countries, “women’s empowerment” remains a pipe dream - little more than a rhetorical flourish added to a politician’s speech. Too many women are still missing out on the opportunity to get educated, support themselves, and obtain the health services they need, when they need them.


Every country should ensure that the future will bring health to all women and girls – whoever they are, wherever they live.

Monday, March 16, 2015

Watch out for those back-breakers

THE HINDU TRICHY

TIRUCHI, March 17, 2015

Watch out for those back-breakers



Unscientifically designed speed-breakers giving nightmare to drivers



Motorists driving in the city often encounter a back-breaking experience because of the unscientifically designed speed-breakers laid at various spots.



Established with varying lengths and heights on different stretches with no uniformity in design and absence of proper markings, the speed-breakers have virtually turned out to be a bane for motorists, complain vehicle users.

In a city where the road safety laws are violated with impunity, speed-breakers were put up at vantage locations on busy thoroughfares to check the accident rate. However, lack of uniformity in sizes of the speed-breakers with no standard specifications is posing problems for the vehicle users — especially for the motorcycle riders and those riding pillion.

Riding over the hump on some of these unscientifically erected speed-breakers itself causes a hurdle for the rider and their pillion. Many speed-breakers have not been laid as per Indian Road Congress norms, says M. Sekaran, member of the Road Safety Committee.

Caution boards to alert road users of the approaching speed-breakers have not been put up at any of these spots which further compounds the problem for the motorists, especially at night, Mr. Sekaran adds.

Many speed-breakers do not have fluorescent white markings to caution the vehicle users, says C. Balasubramanian, president, Tiruchi District Exnora.

The unscientifically designed speed-breakers could themselves lead to accidents if the rider is not extremely careful while passing over them, Mr. Balasubramanian says.

There have been occasions when the authorities concerned laid speed-breakers bowing to public demand, The three fatal accidents on the busy Thanjavur road and the Madurai road a few months ago is a case in point.

The speed-breakers with no uniformity in design were laid on different stretches along the two busy thoroughfares to curb over-speeding. However, none of them have been laid as per proper specifications with markings, Mr. Sekaran said.

Ill designed speed-breakers could strain the spine in neck and back besides causing back pain and sprain at a very early stage to the rider and the pillion, says M.A. Aleem, a city-based neurologist.

At a time when the officials and the police have accident prevention as a priority, scientifically designed speed-breakers become a necessity, says Mr. Balasubramanian.

Thursday, March 12, 2015

Plethora of problems plague city traffic police personnel

Plethora of problems plague city traffic police personnel

TNN | Mar 13, 2015, 01.46 AM IST

Times of India Trichy

TRICHY: Come summers, traffic police personnel invariably bear the brunt of the scorching heat every year. This year, the early onset of summer has exacerbated their problems, including health complications.

Exhausted traffic police personnel leave signals in the afternoon leading to the mess up of vehicular movement. Lack of traffic shelters and uniforms made of polyester cause several health problems to them.

Walking under the scorching sun during summer seasons is always a nightmarish experience for anyone. The situation becomes worse for traffic personnel who have to endure the hot sun and dust particles from early morning till night.

A recent order by the city police commissioner Sanjay Mathur to extend the duty time from 7am to 11pm instead of 8am to 10pm has further worsened their situation. They are not provided with enough basic facilities like proper traffic shelters and refreshments. At least two traffic personnel man one signal in shifts throughout the day.

The shortage of manpower also takes a toll on the staff-crunched city police. Police officials said about 100 traffic police personnel are employed at present in the city.

Interactions with traffic police personnel brought to light the difficulties faced by them during the summer seasons. Their uniform, made of cotton and polyester, also causes nettlesome during summer.

A traffic policeman expressed his anguish over the failure of the department to protect them from heat-related diseases.

"A major problem we face is the lack of shelters at many signals in the city. So, we have face the heat and the pollution which causes serious health problems in the long run," said a traffic policeman seeking anonymity.

For instance, some of the major signals connecting arterial roads are not equipped with full-fledged shelters.

The signals near Head Post Office, Othakkadai, TVS Toll gate, Mannarpuram, SIT, Oil mill are some of the places where shelters are missing. Motorists' ignorance about traffic rules also get on their nerves.

Like last year, the city police are yet to provide refreshments like buttermilk, lemonade and water to traffic police personnel.

Doctors warn of serious health complications if the traffic police personnel are not provided proper facilities.

"The salinity in the body will decrease due to sweating during summer. Traffic police personnel are prone to loss of fluid, muscle cramps, burning urination and irritation in the body. Prickly heat will lead to lack of concentration while on duty leading to confusion in traffic regulation. So, they must consume tender coconut, lemonade, buttermilk, water at regular intervals. Wearing sunglass will protect their eyes from sunlight and pollution. It is advisable to wear cotton dress loosely," said neurologist Dr MA Aleem, former vice-principal of KAP Viswanatham Government Medical College.

Saturday, March 7, 2015

International Women's Day 2015 Theme: MAKE IT HAPPEN

International Women's Day 2015 Theme: MAKE IT HAPPEN

All around the world, International Women's Day represents an opportunity to celebrate the achievements of women while calling for greater equality.

Make It Happen is the 2015 theme which encouraging effective action for advancing and recognising women.

Each year International Women's Day (IWD) is celebrated on March 8. The first International Women's Day was held in 1911.




Friday, March 6, 2015

Too much medicine: the challenge of finding common ground- BMJ⁠ 2015;350:h1163

Editorials

Too much medicine: the challenge of finding common ground

BMJ⁠ 2015⁠; 350⁠ doi: http://dx.doi.org/10.1136/bmj.h1163 (Published 04 March 2015)⁠

Cite this as: BMJ⁠ 2015;350:h1163


Rapid response



Re: Too much medicine: the challenge of finding common ground

All over the world whether patients have insurance or not, all of them have a right to get correct cost effective treatment without unnecessary investigation and excessive medication for their better health

Competing interests: No competing interests

06 March 2015

M A Aleem

Neurologist

ABC Hospital

Annamalainagar Trichy 620018 Tamilnadu India

Turmeric (Manjel in Tamil) In Epilepsy Treatment

Turmeric: May Have Antiseizure Activity




Turmeric (Curcuma longa) is in the same botanical family as ginger (Zingiberaceae). The rhizome is used as a coloring agent and a spice in such foods as curries, and as a medicinal agent in India Particularly in Tamilnadu

Curcumin, a constituent of the turmeric rhizome, is a bright-yellow polyphenolic compound, chemically diferuloylmethane. Preliminary research suggests that turmeric and curcumin have a variety of pharmacologic properties, including anti-inflammatory, antitumor, and antimicrobial activities.

Clinical research in small numbers of patients has been conducted on curcumin for a diverse group of medical conditions, such as osteoarthritis; inflammatory bowel disease; pancreatitis; gastric ulcer; psoriasis; and cancer, including breast, colorectal, pancreatic, and others. Although a search of curcumin on PubMed yields more than 7000 citations, most articles report bench research; no commercial interest has applied for a drug license for any curcumin preparation.

Turmeric In Neurological Disorders

Curcumin is poorly bioavailable, but it is a low-molecular-weight, lipophilic compound, which allows it to be absorbed and penetrate the blood/brain barrier. Some research suggests that curcumin might have neuroprotective and antioxidant activity, which might be useful for treatment of seizures. Studies in several animal models have shown that curcumin can reduce seizures that have been induced chemically or electrically. To date, no clinical trials of curcumin or turmeric for seizures have been published.

Turmeric IN Epilepsy

Turmeric and curcumin are available in the United States as dietary supplements. Both appear to be safe for most people, although no studies demonstrating safety in patients with epilepsy are available. Curcumin did not adversely affect rats concurrently given conventional antiepileptic drugs. Preliminary clinical research suggests that curcumin might inhibit cytochrome P450 (CYP)1A2 and enhance CYP2A6.

In recent research on induced seizures in animals suggests that turmeric or its constituent, curcumin, might have antiseizure effects. However, neither agent has been studied in patients with epilepsy.

-Medscape

Tuesday, March 3, 2015

International Ear Care Day - 3.3.2015

Some 1.1 billion teenagers and young adults are at risk of hearing loss due to the unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues such as nightclubs, bars and sporting events, according to WHO. Hearing loss has potentially devastating consequences for physical and mental health, education and employment.

Data from studies in middle- and high-income countries analysed by WHO indicate that among teenagers and young adults aged 12-35 years, nearly 50% are exposed to unsafe levels of sound from the use of personal audio devices and around 40% are exposed to potentially damaging levels of sound at entertainment venues. Unsafe levels of sounds can be, for example, exposure to in excess of 85 decibles (dB) for eight hours or 100dB for 15 minutes.

“As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss. “They should be aware that once you lose your hearing, it won’t come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk.”

Safe listening depends on the intensity or loudness of sound, and the duration and frequency of listening. Exposure to loud sounds can result in temporary hearing loss or tinnitus which is a ringing sensation in the ear. When the exposure is particularly loud, regular or prolonged, it can lead to permanent damage of the ear’s sensory cells, resulting in irreversible hearing loss.



WHO recommends that the highest permissible level of noise exposure in the workplace is 85 dB up to a maximum of eight hours per day. Many patrons of nightclubs, bars and sporting events are often exposed to even higher levels of sound, and should therefore considerably reduce the duration of exposure. For example, exposure to noise levels of 100 dB, which is typical in such venues, is safe for no more than 15 minutes.

Teenagers and young people can better protect their hearing by keeping the volume down on personal audio devices, wearing earplugs when visiting noisy venues, and using carefully fitted, and, if possible, noise-cancelling earphones/headphones. They can also limit the time spent engaged in noisy activities by taking short listening breaks and restricting the daily use of personal audio devices to less than one hour. With the help of smartphone apps, they can monitor safe listening levels. In addition they should heed the warning signs of hearing loss and get regular hearing check-ups.

Governments also have a role to play by developing and enforcing strict legislation on recreational noise, and by raising awareness of the risks of hearing loss through public information campaigns. Parents, teachers and physicians can educate young people about safe listening, while managers of entertainment venues can respect the safe noise levels set by their respective venues, use sound limiters, and offer earplugs and “chill out” rooms to patrons. Manufacturers can design personal audio devices with safety features and display information about safe listening on products and packaging.

Make Listening Safe initiative

To mark International Ear Care Day, celebrated each year on March 3rd, WHO is launching the “Make Listening Safe” initiative to draw attention to the dangers of unsafe listening and promote safer practices. In collaboration with partners worldwide, WHO will alert young people and their families about the risks of noise-induced hearing loss and advocate towards governments for greater attention to this issue as part of their broader efforts to prevent hearing loss generally.

Worldwide, 360 million people today have moderate to profound hearing loss due to various causes, such as noise, genetic conditions, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, and ageing. It is estimated that half of all cases of hearing loss are avoidable. To address this issue, WHO collates data and information on hearing loss to demonstrate its prevalence, causes and impact as well as opportunities for prevention and management; assists countries to develop and implement programmes for hearing care that are integrated into the primary health-care system; and provides technical resources for training health workers.

Monday, March 2, 2015

International Epilepsy Day-Epilepsia February 2015Volume 56, Issue 2Pages 163–176

Epilepsia

© The International League Against Epilepsy

February 2015

Volume 56, Issue 2

Pages 163–328, e15–e20



From the editors: Global awareness and International Epilepsy Day (page 167)

Gary W. Mathern and Astrid Nehlig

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12817

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Letter: World Epilepsy Day (page 168)

MA Aleem

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12814

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Response: International Epilepsy Day (pages 169–170)

Ann Little

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12816

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Commentary: Why an International Epilepsy Day? (pages 170–171)

Emilio Perucca

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12813

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Commentary: International Epilepsy Day (page 172)

Sándor Beniczky

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12819

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Commentary: International Epilepsy Day (pages 173–174)

Byung-In Lee

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12821

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Commentary: International Epilepsy Day (page 174)

Sheryl Haut

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12820

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Commentary: International Epilepsy Day (page 175)

Steve Roberds

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12818

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Commentary: International Epilepsy Day (page 176)

Diane Stein

Article first published online: 17 NOV 2014 | DOI: 10.1111/epi.12823

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